Individual
MS. AMANDA ALYSSA GAUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
40 SUSAN LN APT 2, ROCHESTER, NY 14616-4909
(585) 305-3508
Mailing address
40 SUSAN LN APT 2, ROCHESTER, NY 14616-4909
(585) 305-3508
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
328925
NY
Other
Enumeration date
07/08/2019
Last updated
07/08/2019
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